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Trial registered on ANZCTR
Registration number
ACTRN12619000495123
Ethics application status
Approved
Date submitted
17/03/2019
Date registered
26/03/2019
Date last updated
25/05/2023
Date data sharing statement initially provided
26/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Emergence characteristics comparing Endotrachael tube vs Laryngeal Mask airway during nasal surgery with general anaesthesia using intravenous anaesthetic agents like propofol and remifentanyl.
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Scientific title
Emergence characteristics comparing ETT to Reinforced LMA using remifentanil and Propanol during intra nasal surgery- Prospective randomized study
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Secondary ID [1]
297733
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anaesthesiology
312061
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Condition category
Condition code
Anaesthesiology
310625
310625
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After randomisation they will be allocated to either group A or B. In group A RAE tube size 7 will be used in females and 8 in males. In group B RLMA size 3 or 4 (Flexiplus) will be used in females and males based on the patient recommended body weight. Correct insertion of either airway will be confirmed by the ability to manually ventilate the patient’s lungs and adequate cuff inflation by the absence of an audible gas leak when at the APL valve setting of 15-20cmH2o. Throat pack will be inserted to all participants in the group A to reduce the risk of contamination. In group B it is not inserted, because of the minimal space, with possibility of displacing the RLMA. Blood and secretions from the pharynx contaminating the trachea is prevented by regular suction by the surgeon. Though in group B when RLMA is inserted without the use of muscle relaxants, adequate depth of anaesthesia maintained with total intravenous anaesthesia method and ventilation setting will be pressure controlled ventilation to maintain the eTCO2 in normal limits. Failure of RLMA insertion will be backed with ETT intubation. Blood loss will be measured during intraoperatively and in the postoperative period. At the conclusion of surgery, with anaesthesia maintained, surgeon performs fiberoptic endoscopy to inspect the interior of the laryngeal mask above the larynx or the tracheal tube to its tip. Anaesthetist performs oral suction above the RLMA with the cuff inflated before removal, when the patient is awake and responding to command. Once the patient is extubated, the RLMA airway is examined for the grading of the contamination. Grade 1- Clean, Grade2-lightly soiled, Grade 3-fully soiled and Grade 4 blood inside the RMLA. No strategies but any deviation from protocol a note recorded in data sheet.
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Intervention code [1]
313971
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Prevention
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Comparator / control treatment
Reinforced LMA
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Control group
Active
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Outcomes
Primary outcome [1]
319473
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time taken to opening eyes on command or respond after termination of the anaesthetic agents
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Assessment method [1]
319473
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Timepoint [1]
319473
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Immediately after the termination of the anaesthesia
Outcome Assessment is done by the assistant using timer on monitor
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Secondary outcome [1]
368315
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haemodynamic response to emergence from anaesthesia
Outcome measured is Mean arterial BP mesuared by non invasive Blood pressure by manual sphygmomanometer prior, at and after extubation
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Assessment method [1]
368315
0
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Timepoint [1]
368315
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at the extubation time
Haemodynamic outcome is Mean arterial BP which is measured 2 sets by prior, at and after extubation
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Secondary outcome [2]
368316
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adverse effects on return of airway reflexes like cough and laryngospasm, aspiration of blood, post-operative sore throat
Outcomes measured by observations of events
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Assessment method [2]
368316
0
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Timepoint [2]
368316
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at emergence
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Secondary outcome [3]
368317
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grading the contamination of the Reinforced laryngeal mask airway (RLMA )
Outcome measured by observing the RMLA and referring to grading given in the protocol.( grading of LMA is as follows: Grade 1- Clean, Grade2-lightly soiled, Grade 3-fully soiled and Grade 4 blood inside the RMLA.
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Assessment method [3]
368317
0
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Timepoint [3]
368317
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after extubation
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Secondary outcome [4]
368318
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cost difference between the groups.
Resource: Hospital pharmacy and business manager who know the consumable costs
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Assessment method [4]
368318
0
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Timepoint [4]
368318
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end of the study
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Eligibility
Key inclusion criteria
Age between 18-80yrs, ASA I–III scheduled for elective rhinoplasty, mini endoscopic surgery, nasal septal or any other intranasal surgery will be included
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients were excluded if they had a known history of obesity, reflux or hiatus hernia, reflux risk with previous surgery on the oesophagus and extensive pathology on CT scan requiring complex surgery expecting major blood loss. Other exclusion may be in situations of RLMA leakage causing fog or splashes of blood on the endoscopy lens, which could make the surgery difficult requiring, change the RLMA to tracheal tube.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Safety
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Statistical methods / analysis
Continuous variables by the “t”-test; categorical variables by Fisher's exact test.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
27/03/2019
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Actual
4/04/2019
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Date of last participant enrolment
Anticipated
15/06/2022
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Actual
15/06/2022
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Date of last data collection
Anticipated
30/06/2022
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Actual
30/06/2022
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Sample size
Target
72
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Accrual to date
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Final
72
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
13424
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The Queen Elizabeth Hospital - Woodville
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Recruitment postcode(s) [1]
26026
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5011 - Woodville
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Funding & Sponsors
Funding source category [1]
302260
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Hospital
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Name [1]
302260
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Anaethesia The Queen Elizabeth Hospital
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Address [1]
302260
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Anaethesia The Queen Elizabeth Hospital 28 woodville rd
Woodville South 5011 SA
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Country [1]
302260
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Australia
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Primary sponsor type
Hospital
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Name
Anaethesia The Queen Elizabeth Hospital
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Address
Anaethesia The Queen Elizabeth Hospital 28 woodville rd
Woodville South 5011 SA
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Country
Australia
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Secondary sponsor category [1]
302122
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None
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Name [1]
302122
0
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Address [1]
302122
0
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Country [1]
302122
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302936
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Central Adelaide Local Health Network Human Research Ethics Committee
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Ethics committee address [1]
302936
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Central Adelaide Local Health Network Human Research Ethics Committee Human Research Ethics Committee Woodville SA
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Ethics committee country [1]
302936
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Australia
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Date submitted for ethics approval [1]
302936
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15/10/2018
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Approval date [1]
302936
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21/12/2018
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Ethics approval number [1]
302936
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HREC/18/CALHN/680
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Summary
Brief summary
Traditionally ETT is used for the nose surgery for maintenance and protection of the airway during anaesthesia and recovery. There are only a few studies comparing reinforced laryngeal mask airway to ETT and these have shown similar efficacy in achieving the above functions. Reinforced laryngeal mask( RLMA) have been shown however to have a lower incidence of hoarseness, coughing during recovery in the post-anaesthesia care unit (PACU) and oxygen desaturation than patients treated with ETT . There is a paucity of literature on the use of RLMA and emergence characteristics. There are no trials examining the emergence characteristics of patients ventilated with ETT vs RLMA using remifentanil and Propofol. . We wanted to assess the RLMA for the suitability of its use in intranasal surgery (INS) and assess its safety during the surgery and emergence characteristics at the end of surgery.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
91902
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A/Prof Vasanth Rao Kadam
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Address
91902
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The Queen Elizabeth hospital, Anaesthesia. 28 woodville rd
Woodville South 5011 SA
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Country
91902
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Australia
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Phone
91902
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+61 882226000
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Fax
91902
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+61882227065
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Email
91902
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[email protected]
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Contact person for public queries
Name
91903
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Vasanth Rao Kadam
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Address
91903
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The Queen Elizabeth hospital
28 woodville rd
Woodville South 5011 SA
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Country
91903
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Australia
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Phone
91903
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+61 882226000
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Fax
91903
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+61882227065
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Email
91903
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[email protected]
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Contact person for scientific queries
Name
91904
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Vasanth Rao Kadam
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Address
91904
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The Queen Elizabeth hospital
28 woodville rd
Woodville South 5011 SA
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Country
91904
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Australia
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Phone
91904
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+61 882226000
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Fax
91904
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+61882227065
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Email
91904
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
7367
Ethical approval
No data shared methods proposed at this time
377211-(Uploaded-13-03-2020-18-46-23)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF